When is Endoscopic DCR Recommended?

1. Nasolacrimal Duct Obstruction

Congenital or acquired blockage causing persistent tearing.

2. Recurrent Lacrimal Sac Infections (Dacryocystitis)

Repeated infections despite medical treatment.

3. Post-Traumatic or Iatrogenic Obstruction

Obstruction due to injury or prior nasal/facial surgery.

4. Functional Epiphora

Tearing due to poor drainage despite patent ducts — may be evaluated and treated during surgery.

Symptoms That Suggest a Blocked Tear Duct

• Constant watering or overflow of tears (epiphora)
• Recurrent eye redness or discharge
• Painful swelling near the inner corner of the eye
• Recurrent infections of the lacrimal sac

Diagnosis & Pre-operative Evaluation

A careful assessment determines the site and cause of obstruction and helps plan surgery.

• Clinical history and examination of the lacrimal drainage system
• Lacrimal syringing & probing to test patency
• Dacryocystography or CT dacryocystography in selected cases
• Nasal endoscopy to assess intranasal anatomy and pathology

How Endoscopic DCR Is Performed

The procedure is typically performed under general or local anaesthesia with sedation and includes the following steps:

• Nasal endoscope insertion to view the lateral nasal wall and lacrimal sac region
• Creation of a small window in the lateral nasal wall and removal of the thin bone over the lacrimal sac
• Opening the lacrimal sac and creating a new drainage pathway into the nose
• Optional placement of temporary silicone stents (dacryocystorhinostomy tubes) to maintain patency during healing
• Addressing concomitant nasal problems (polyps, deviated septum) during the same procedure if needed

Endoscopic DCR avoids external scars and allows simultaneous treatment of intranasal disease, with comparable success rates to external DCR in many hands.

Benefits, Recovery & Aftercare

Benefits

• No external incision or facial scar
• Improved visualization of nasal cavity and lacrimal sac
• Ability to treat nasal pathology simultaneously

Recovery & Aftercare

• Most patients go home the same day or after an overnight stay
• Mild nasal bleeding, crusting, and congestion are common for a few days
• Nasal saline washes and topical antibiotics/ointments as prescribed
• Stent removal (if placed) is typically done after 4–12 weeks depending on the surgeon’s protocol
• Regular nasal endoscopic follow-up to clear crusts and monitor the opening

Possible Complications

• Persistent epiphora if the new opening closes (may require revision)
• Minor nasal bleeding, infection, or crusting
• Rare injury to nearby structures (orbital area) — uncommon with experienced surgeons

Overall success rates are high, and careful follow-up with nasal endoscopy and stent management reduces the chance of failure.

Why Choose Dr. Shrekha Padmakshan for Endoscopic DCR?

Dr. Shrekha Padmakshan offers multidisciplinary expertise in lacrimal and nasal surgery, combining otolaryngology and oculoplastic principles to deliver optimal results.

• Advanced endoscopic skills with high success rates
• Ability to manage both nasal and lacrimal pathology in one procedure
• Personalized care, meticulous surgical technique, and thorough follow-up
• Access to modern endoscopic and imaging equipment

If you have persistent tearing, recurrent lacrimal infections, or symptomatic tear duct blockage, book a consultation to evaluate whether Endoscopic DCR is the right solution for you. Early assessment and proper follow-up ensure the best outcomes.